STDs and unplanned pregnancies are on the rise in women in their 20s and 30s. WH reveals how a casual attitude can have life-altering consequences

"I don't ask questions that I don't want to know the answers to," says 27-year-old Jenny* with a laugh.

That's why she hasn't asked the three men she's currently sleeping with about their sexual pasts. And when they inquire about hers, she lies. They don't know she's had sex with dozens of guys—instead she cops to six, the magic number that she and her friends have decided sounds most acceptable.

For now, Jenny is focused on her public relations career in Philadelphia and has no interest in pursuing a committed relationship. "If you're with multiple people, you can't get your heart broken," she says. Having casual sex keeps her safe, at least emotionally. There's the dude downstairs—a friend's ex—with whom she could never have a relationship outside the bedroom. There's the old pal who is "just a friend with benefits, nothing else," who sends her late night booty text messages. "I'll go over and we'll have sex, and then I won't hear from him for two weeks," she says. "And I'm totally cool with it."

Cool, too, with the new rituals of the mating-without-dating culture. There are the naked self-portraits she fires out from her BlackBerry. "I send them if I want to entice the guy to have sex," she says, adding that she would "absolutely die" if the racy photos got out. There's the boozing herself loose for sexual encounters ("Alcohol is always involved because it makes you bold enough to act and feel a certain way"), even though she tends to have unsafe sex when she's wasted. There are the hit-or-miss protective measures ("I don't always use condoms—I take morning-after pills when I need to"), even though she assumes that the men she sleeps with are intimate with other women too. "I don't really worry about HIV anymore," she says. "It's like I think I'm invincible. Nothing bad can possibly happen to me."

Jenny's cavalier attitude is shocking, but not uncommon. Plenty of young women today are shoe-horning active sex lives into ambitious professional pursuits that don't allow time for traditional dating, feeling Teflon-protected in the face of very real repercussions. "Sexually transmitted diseases and unplanned pregnancies are hugely on the rise," says sex therapist Laura Berman, M.D., a clinical professor of psychiatry and OBGYN at Northwestern University. "Unprotected anal and oral sex, being with multiple partners, not having regular testing or regular Pap smears, drinking...all of these things create a perfect storm for putting yourself at higher risk."

The STD Uptick
Syphilis, gonorrhea, chlamydia, herpes, HPV, HIV...not only are these sexually transmitted diseases all on the rise, according to a recent report from the Centers for Disease Control and Prevention (CDC), but they also pose "a particularly heavy burden on women."

• Syphilis, once on the verge of elimination, increased 15.2 percent between 2006 and 2007 (the last year that data is available), and is now striking more women and their infants than ever.

• Reported cases of chlamydia (which can lead to infertility) and gonorrhea—estimated to represent only half of actual cases since so many go undiagnosed—were the highest in history in 2007, with the rate of chlamydia among women three times that of men.

• Females now account for more than a quarter of all new HIV/ AIDS diagnoses, with high-risk heterosexual contact the source of 80 percent of these newly diagnosed infections.

• Hepatitis B, which is 50 to 100 times more infectious than HIV, often causes no symptoms. People may not know they're infected until they develop serious liver disease.

• And HPV—which is responsible for causing 70 percent of cervical cancer and 90 percent of genital warts cases—has become the most common STD on the planet, and it's spreading at epidemic rates: About 25 million women in the U.S. are currently infected, according to the CDC, and another 6.2 million are newly diagnosed each year.

"The public is blissfully ignorant that so many of these diseases are on the rise. Anybody who has ever had sex has probably been exposed to HPV," says medical sociologist Adina Nack, Ph.D., author of Damaged Goods?, about living with STDs. "The consequences are serious and real. Are people thinking along those lines when they're making their safer-sex or not-safer-sex decisions?"

Apparently not. Drew Pinsky, M.D. (aka Dr. Drew), host of the nationally syndicated show Loveline, offers one explanation for the lax behavior. "There was a pushback to the scare tactics of the '80s and '90s HIV campaign," he says. "What's always true is that if you overstate your case, young people will not only return to the behavior you're trying to control, but they'll go above. So we've started seeing some riskier behaviors. All the messages about STDs started getting lost, and now we have a real problem."

One of those riskier behaviors is the ditching of condoms: Studies show that even as young women are sleeping with ever-increasing numbers of men, they are using latex less often. A study published in 2008 in Perspectives on Sexual and Reproductive Health found that women who had two or more partners in the past year were more likely to be inconsistent contraceptive users, and only 51 percent of condom users used one every single time in the three months prior to the study.

"Frankly, I know a lot of very smart women who rarely use condoms," says 30-year-old Amelia Parry, editor of TheFrisky.com, a website that focuses on celebrities, dating, sex, and relationships. "They go to the gym five days a week, but they don't insist that the guy wear a condom? That's insane."

In fact, many aren't using birth control at all, which explains why almost 70 percent of all unplanned pregnancies are had by unmarried women in their twenties, according to a 2009 study by the National Campaign to Prevent Teen and Unplanned Pregnancy. The organization just completed the first nationally representative survey of single young adults, ages 18 through 29, and found that although young women say they don't want to get pregnant, they are not careful with contraception. "They said they expect to have unprotected sex in the next year. It's not like 'Oops, it happened.' They know it's going to happen," says the campaign's CEO, Sarah S. Brown.

But, like Jenny, they feel invulnerable to the consequences, and that carefree attitude extends to other risky behaviors, including the sharing of explicit pictures of themselves with their potential hook-ups. Nancy, a 33-year-old vice president of a public relations agency in New York, is firmly embedded in the casual-sex ethos and sends nude photos of herself to guys she's interested in. She compares the appeal of "sexting" to the "instant gratification of a love letter. Turning men on is a turn-on, and they are so easy," she says.

Nancy is not alone in her exhibitionist activities. A recent survey from the National Campaign to Prevent Teen and Unplanned Pregnancy found that 36 percent of 20-something women had sent out nude pictures of themselves, 80 percent of whom said it was to get a guy's attention. Unfortunately, these women are getting more than that guy's attention: Forty percent of men in their twenties say they've been sent nude photos that were originally sent to someone else.

But consequences are an afterthought, as Chicago resident Jessica Voth found out after her ex-boyfriend posted nude photos of her on a website that encourages guys to download sexual snapshots of their former flames. After not leaving her condo for more than a month, except to go to work, she filed suit for emotional distress and invasion of privacy for becoming an unwitting pinup, but there's no amount of monetary compensation that can undo the humiliation she has felt.

Kristy, 27, an administrator at a children's mental health agency, has suffered significantly more than humiliation as the result of having unprotected sex at age 18. One year after Kristy's twin daughters were born, she was diagnosed with HPV, which she was unknowingly infected with the night she got pregnant. Today—even after having invasive laser, chemotherapy, and injection treatments—her vagina remains crusted over with cauliflower-like genital warts.

Even worse, the infection was transmitted during delivery to one of her daughters, who now has warts around her anus and vagina, growths that are so painful, she has trouble going to the bathroom. "How do you tell your 8-year-old daughter that she has an STD?" asks Kristy, who still feels blindsided by the life-altering aftermath of one night of risky sex.

The Invulnerable Generation
When 26-year-old Whitney, who works in the finance industry in Boston, was in college, her friends teased her about attaching herself to a serious boyfriend. "They'd be like, 'You only get one chance to have fun in college and hook up with tons of guys. Why would you stay with one person?' " she says. "Sleeping around was not really what I wanted or needed, but I felt pressured." So she took occasional "breaks" from her boyfriend and had mostly unprotected "sexual rampages" with her crush of the moment. Back with her college sweetheart today, she's still horrified about buying into the anonymous-sex scene at school.

"Women feel like they have to hook up," Dr. Drew explains. "It's so institutionalized that they feel like something is wrong with them if they're not having fun with it. And the hook-up culture knocks aside the fear of consequences."

"Hooking up is definitely not stigmatized, and I don't think it should be," says TheFrisky.com's Parry, who knows plenty of "single and mingling" women who are in the habit of chasing their cosmos with casual sex. "I don't think there's anything wrong with people having multiple sexual partners, as long as they're being safe. The question is, are they being safe and are they being honest about having multiple partners? How much can you really trust somebody? To a certain degree, you never know, which is disconcerting. And I think it makes people so uncomfortable that they'd rather not think about it at all."

Alcohol certainly helps women not think about it. That the booze-and-sex cocktail is a risky mix was confirmed in a 2008 study from Johns Hopkins University Medical School, which found that women who binge drink are more likely to indulge in unsafe sex: They are three times more likely to have anal sex, twice as likely to have multiple sexual partners, and five times more likely to have gonorrhea as nondrinking women.

Nancy, who has had about 30 sexual partners and says that alcohol "is a big thing," admits she's not overly concerned with the fallout of latex-free sex with multiple partners. She doesn't always use condoms, and never for oral sex. "I do oral all the time. I don't use protection," she says. And yet unprotected oral sex may be one of the most widespread and most dangerous sexual practices for women's health. Oral and throat cancers have recently been causally linked to the same HPV strains that cause cervical cancer; herpes, chlamydia, and gonorrhea also can be easily transmitted from mouth-to- genital contact, though many women are completely unaware of the risk. "I had no idea you could get herpes from oral sex," says Wendy, a 37-year-old teacher from Colorado who recently contracted genital herpes after receiving oral sex from a boyfriend. He never told her about his infection. "Now who is ever going to want to be with me and deal with this crap?"

Some experts blame eight years of abstinence-only education— the only sex ed that was federally funded under President George W. Bush—for not only failing to inform younger women about the dangers of unprotected oral sex, but also for actually fueling its popularity. "A lot of teenagers reduced the message to 'I must abstain from the kind of sex that makes a baby,' " says Nack. For young women, oral sex pleased their partners and preserved their virginity, as did anal sex, another risky sexual behavior that's becoming more prevalent. According to the CDC's National Survey of Family Growth, nearly 35 percent of women ages 25 to 44 engage in anal sex.

"Women are complying with anal sex to the point that they're damaging themselves," says Dr. Drew, who notes that today's young men are obsessed with the practice thanks to its prominence in porn. "No matter how much it hurts, the women are like, 'Well, I want to make him happy.' It's the most bizarre thing in the world."

The Pressure to be Edgy
Of course, some women do derive pleasure from anal sex; the problem is that, like with oral sex, many don't use protection, and because the rectum lacks natural lubrication, the resulting tiny tears are perfect entry points for STDs. "It's much riskier than vaginal sex," Berman says. "HPV anal cancer is hugely on the rise, and most experts believe it's because of anal intercourse."

But among 20-something women, anal sex seems to have become the badge of a sexually adventurous soul. "It has become a new symbol for young women of a kind of sexual fluency: 'I'm sexually progressive, therefore I have anal sex,' " says Jenny Higgins, Ph.D., an assistant professor at Columbia University who researches women's sexuality. "Part of me feels like, 'Right on—if we want to expand the sexual repertoire, then fabulous,' but I really wonder if women are getting as much sexual satisfaction out of this as men are."

So why do they do it? A cultural pressure to be sexually liberated, she says, is driving so many of these dicey sexual practices. Dr. Drew agrees: "Rather than asserting their needs and autonomously presenting them, women are adopting the male point of view, taking it on, even though it isn't for their benefit and it's a kind of disempowerment. I think that's at the core of this." Based on the endless conversations with students at colleges where he speaks across the country, he concludes that "these sexual interactions make men very happy, but they do not make women very happy."

Women who appropriate male sexual behavior, who throw out the booty text because that's what a man (and therefore a modern woman) does, are only hurting themselves, Berman says. "The bottom line is that whether they like it or not, women are wired differently than guys are. When we do have good sex with someone, even if it's someone we wouldn't want to have an actual relationship with, our brains are washed with oxytocin, the chemical of attachment, and then we get all flipped out when he doesn't call the next day," she says. Women go into a dissociative state around their sexuality, she says, and have to lie to themselves—"I don't care, I'm just like a guy"—to believe otherwise.

Of course, not everyone agrees with that point of view. "I don't like that perspective, because I think it victimizes women. I think it's really condescending," Parry says. "I think, in general, women are in control of their sexuality and have sex when they want to. I don't think it can be boiled down to women buying into what men are telling them. Women are a hell of a lot smarter than that."

What it comes down to, Nack says, is that there's a lot of sex in our culture but a surprising lack of knowledge about how to keep ourselves sexually healthy. "And we can become caught up in the morality of it and lose track of the health side of it," she says.

A Big Disconnect
Cute undies and shaved legs. Those are the things Diana, a 24-year-old staffing agency manager, makes sure she has every weekend when she heads out to the bars of New York. "Hooking up is something to do until I find someone. It's not a problem meeting a guy and going home with him. It's easy. There's more opportunity for that than for dating," she says of no-strings-attached sex—the perfect guy being someone she has no long-term interest in. ("If I start to crush on him, it gets tougher to have a sexual relationship," she says.) Everyone, she says, is looking for the same thing: random sex. "Play or be played" is how she puts it. "Alcohol is a big factor, huge. It's liquid courage. You don't have any inhibitions: 'I can do this...I can hit on this guy,' " Diana says. She has slept with 32 men in the six years since she lost her virginity, and she doesn't care if anyone tries to "slut-shame" her: "I'm not ashamed of it. Other people can judge, but it's you who ultimately needs to be OK with your decisions."

Still, even Diana is not OK with her all-too-frequent unsafe-sex decisions. Condom fatigue? Pregnancy ambivalence? It's a rational disconnect she just can't explain. While she is "paranoid" and has STD tests every six months, and she gets furious with her friends—four of whom have HPV—who sleep around and don't use protection ("I'm like, 'You are the reason I am paranoid. It's girls like you who spread it around and make it dangerous for me"), she still doesn't always protect herself. "I've definitely made my share of mistakes and continue to do so, usually in the heat of the moment or when I'm intoxicated," Diana says. "The morning after these things happen, I'm sick to my stomach. I feel so bad about making such a stupid mistake. I'm hoping that I don't have to learn the hard way to stop doing it."

*Some names and identifying details have been changed.

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